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allowed-amounts-multiple-plan-sample.json
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allowed-amounts-multiple-plan-sample.json
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{
"reporting_entity_name": "cms",
"reporting_entity_type": "cms",
"last_updated_on": "2020-08-27",
"version": "1.0.0",
"out_of_network":[{
"name": "Established Patient Office or Other Outpatient Services",
"billing_code_type": "CPT",
"billing_code_type_version": "2020",
"billing_code": "99214",
"description": "office or other outpatient visits for the evaluation and management of an established patient, which requires at least two of these three key components: a detailed history, a detailed examination and medical decision making of moderate complexity",
"allowed_amounts": [{
"tin": {
"type": "ein",
"value": "1234567890"
},
"service_code": ["01", "02", "03"],
"billing_class": "professional",
"payments": [{
"allowed_amount": 25.00,
"providers": [{
"billed_charge": 50.00,
"npi": [1234567891,1234567892,1234567893]
},{
"billed_charge": 60.00,
"npi": [1111111111]
},{
"billed_charge": 70.00,
"npi": [2222222222,3333333333,4444444444,5555555555]
}]
}]
}]
}]
}